NOTICE OF PRIVACY PRACTICES

TABLE OF CONTENTS

1. How This Medical Practice May Use or Disclose Your Health Information

2. When This Medical Practice May Not Use or Disclose Your Health Information

3. Your Health Information Rights

3-1. Right to Request Special Privacy Protections

3-2. Right to Request Confidential Communications

3-3. Right to Inspect and Copy

3-4. Right to Amend or Supplement

3-5. Right to an Accounting of Disclosures

3-6. Right to a Paper or Electronic Copy of this Notice

4. Changes to this Notice of Privacy Practices

5. Complaints